Strengthening keratoconus management systems in South African public sector facilities

Abstract

Background: Provision of comprehensive eye care remains a challenge in low to medium income countries including South Africa. The recent surge of keratoconus (KC) is exacerbating this challenge especially in terms of the need for specialised equipment, optical devices, and quality knowledgeable eyecare workforce necessary for KC management.

Aim: This study aimed to analyse the capacity of the public sector facilities in the provision of eyecare service to KC patients in view of developing strategies for strengthening systems for efficiency and effectiveness of KC patient care.

Setting: Public sector hospitals of Capricorn District, Limpopo Province, South Africa.

Methods: Concurrent mixed methods triangulation which included document review of clinical reports on patient headcount, cross-sectional survey of available equipment, working space and eyecare workforce, and key stakeholder and focus group interviews for exploring the perspectives of optometrists on eyecare service provision was conducted.

Results: A significant patient headcount of consulting patients and well-established outreach programmes were reported. Limited knowledge of KC and severe shortages of basic equipment, consumables, and optical devices associated with financial constraints were commonly reported barriers to service provision to KC patients.

Conclusion: The district has made progress in setting up systems for eyecare provision though gaps were identified in the service offered to KC patients. More efforts are required to strengthen the systems in this district for improvement of this service.

Contribution: This article seeks to highlight the capacity of the public sector as the main contributor to eyecare and to strengthen systems for KC patient care.